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*Postbulbar ulcers should raise the possibility of Zollinger-Ellison syndrome especially if ulcers are multiple and gastric folds are thickened
*Postbulbar ulcers should raise the possibility of Zollinger-Ellison syndrome especially if ulcers are multiple and gastric folds are thickened
*The oedematous collar of swollen mucosa (to be distinguished from the rolled edges of a malignant ulcer) radiating folds of mucosa away from the ulcer
*The oedematous collar of swollen mucosa (to be distinguished from the rolled edges of a malignant ulcer) radiating folds of mucosa away from the ulcer
*Benign ulcer is seen as filling defect that surrounds the ulcer, as a result of edema, is smooth and symmetrical and merges with the healthy mucosa. The mucosal folds radiate to the edge of the ulcer.<ref name="pmid19999206">{{cite journal |vauthors=Nawaz M, Jehanzaib M, Khan K, Zari M |title=Role of barium meal examination in diagnosis of peptic ulcer |journal=J Ayub Med Coll Abbottabad |volume=20 |issue=4 |pages=59–61 |year=2008 |pmid=19999206 |doi= |url=}}</ref>
*Benign ulcer is seen as filling defect that surrounds the ulcer, as a result of edema, is smooth and symmetrical and merges with the healthy mucosa. The mucosal folds radiate to the edge of the ulcer
smooth rounded and deep ulcer crater
smooth ulcer mound
smooth gastric folds that reach the margin of the ulcer
Hampton's line<ref name="pmid19999206">{{cite journal |vauthors=Nawaz M, Jehanzaib M, Khan K, Zari M |title=Role of barium meal examination in diagnosis of peptic ulcer |journal=J Ayub Med Coll Abbottabad |volume=20 |issue=4 |pages=59–61 |year=2008 |pmid=19999206 |doi= |url=}}</ref>
Features suggesting malignant gastric ulcer
does not protrude beyond the gastric contour (endoluminal)
irregular and shallow ulcer crater
nodular and angular ulcer mound
nodular gastric folds that do not reach the ulcer margin
Carman meniscus sign
References
References
{{reflist|2}}
{{reflist|2}}

Revision as of 01:18, 12 November 2017


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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ;Associate Editor(s)-in-Chief: Manpreet Kaur, MD [2]

Overview

If a peptic ulcer perforates, air will leak from the inside of the gastrointestinal tract (which always contains some air) to the peritoneal cavity (which normally never contains air). This leads to "free gas" within the peritoneal cavity. If the patient stands erect, as when having a chest X-ray, the gas will float to a position underneath the diaphragm. Therefore, gas in the peritoneal cavity, shown on an erect chest X-ray or supine lateral abdominal X-ray, is an omen of perforated peptic ulcer disease.

X Ray

There are no findings seen on X-ray abdomen but complications of peptic ulcer like peptic ulcer perforation findings can be seen on erect X-ray abdomen and chest X-ray is free air under the diaphragm called as pneumoperitoneum[1][2]

Barium swallow

The peptic ulcer can be diagnosed using barium swallow.Barium swallow helps to distinguish between benign and malignant ulcer. Various findings can be seen in barium swallow: The pocket of barium filling the ulcer crater round and linear

  • Postbulbar ulcers should raise the possibility of Zollinger-Ellison syndrome especially if ulcers are multiple and gastric folds are thickened
  • The oedematous collar of swollen mucosa (to be distinguished from the rolled edges of a malignant ulcer) radiating folds of mucosa away from the ulcer
  • Benign ulcer is seen as filling defect that surrounds the ulcer, as a result of edema, is smooth and symmetrical and merges with the healthy mucosa. The mucosal folds radiate to the edge of the ulcer

smooth rounded and deep ulcer crater smooth ulcer mound smooth gastric folds that reach the margin of the ulcer Hampton's line[3] Features suggesting malignant gastric ulcer does not protrude beyond the gastric contour (endoluminal) irregular and shallow ulcer crater nodular and angular ulcer mound nodular gastric folds that do not reach the ulcer margin Carman meniscus sign References

  1. {{cite journal |vauthors=Søreide K, Thorsen K, Harrison EM, Bingener J, Møller MH, Ohene-Yeboah M, Søreide JA |title=Perforated peptic ulcer |journal=Lancet |volume=386 |issue=10000 |pages=1288–1298 |year=2015 |pmid=26460663 |pmc=4618390 |doi=10.1016/S0140-6736(15)00276-7 |url
  2. Thorsen K, Glomsaker TB, von Meer A, Søreide K, Søreide JA (2011). "Trends in diagnosis and surgical management of patients with perforated peptic ulcer". J. Gastrointest. Surg. 15 (8): 1329–35. doi:10.1007/s11605-011-1482-1. PMC 3145078. PMID 21567292.
  3. Nawaz M, Jehanzaib M, Khan K, Zari M (2008). "Role of barium meal examination in diagnosis of peptic ulcer". J Ayub Med Coll Abbottabad. 20 (4): 59–61. PMID 19999206.


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